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How did this happen?

Discussion in 'Parents of Children with Type 1' started by dshull, Feb 25, 2013.

  1. dshull

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    We had a very odd situation last night which is OK now but I am really racking my brain with how it happened. Curious if anyone has any ideas.

    DS was diagnosed 6 months ago and is honeymooning. No long acting insulin, only humalog with meals. Yesterday afternoon he played with friends at the park and when we got home, was 92. Lunch insulin was gone so he had no IOB. At dinnertime, his BG was 169, so I gave him 2.5 units for his upcoming dinner and set the timer for 15 minutes like always. Timer goes off and we start eating. He says he feels low, I check and he is 84. Weird because the insulin has only been in for 20 minutes. 3 minutes later, he says he's low again and I check and he is 48. So how in 20-25 minutes can he drop so far when he just had the injection? Gave him some juice and he came right back up. Then by 8:30 he's 366.

    He stayed high for awhile, we gave a half correction and he bounced up and down until the numbers settled down around midnight. I think he had a rebound high from dropping so low so fast.

    But my question is - insulin does not work that fast, so how could he drop 120+ points in just 20 minutes?

    I know there may be no answer but really I can't figure it out, and it's driving me crazy. Any suggestions or ideas? Of course now I worry this will happen again at school today.
     
  2. Jordansmom

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    If the same thing happened to us, I'd guess the 169 was an incorrect meter reading and that he was actually on the low side (around the 84 reading you got) and prebolusing kicked in and dropped him to the 48. There was time for the drop from 84 to 48. It's just less likely that earlier than that the prebolusing brought him from 169 to 84.

    But honeymooning kids do kick in their own insulin randomly, so there's always that as a guess as well.
     
  3. MomofSweetOne

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    When we get really fast lows after a meal, it's usually a flu bug hitting that's affecting carb absorption.
     
  4. kyle and ryans mom

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    When my son was in the honeymoon period, this would happen. The pancreas is still making some insulin and you never know when it tries to work.
     
  5. Sarah Maddie's Mom

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    1. Honeymoon
    2. Delayed dip from earlier exercise
    3. Meter error
    4. He has Type 1 :cool:

    Sometime there is no clear answer, it just happens.:cwds:
     
  6. dshull

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    Cracking me up with #4, because that is exactly what I thought, too. I thought the 169 was an error when I saw it, so I cleaned off another finger and got the same thing. Just glad this happened at home where no one freaked out and it was resolved quickly.

    Thanks for your ideas!
     
  7. Christopher

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    #5 It is Sunday :eek:
     
  8. Amy C.

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    It was the activity that brought him low, not the insulin. There wasn't enough time for the insulin to kick in.
     
  9. 3kidlets

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    No good answer but Hana has this happen frequently.

    Possibly could be because of Honeymooning though. Maybe his pancreas decided to join in?
     
  10. kiwikid

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    I'd blame it on the exercise at the park.... :cwds:
     
  11. obtainedmist

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    That would be my assumption too!
     
  12. SarahKelly

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    I would definitely think it was the playing at the park, if you see this pattern I'd wait to dose insulin for a meal following activity until you see a number that is rising. So if you check pre-meal and he's 100, let him eat, check about 15-20 min post meal and if he's higher than dose him for the meal, maybe even just part of the meal depending upon how much protein/carbs/fat are in the meal. Also, we had a very difficult time pre-dosing for any meal the first year post dx as Isaac would always go low if we did, he definitely had a long honeymoon - now that it's pretty much over we still only pre-dose for half the meal.
     
  13. quiltinmom

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    This is my thought. The low could have been caused by playing at the park. The highs could have been a rebound, or could've been from eating more carbs than were dosed for. Sometimes I have a tendency to over correct for lows, especially for the lower lows.

    Others might not agree with this, but until I see a pattern in something, I try not to obsess over what happened one time. There are so many things that turn out to be "flukes" that there's not enough "emotional capital" to worry over all of them. If I can figure it out that's great, but if I can't, I try to let it go.

    Patterns are what we spend most of our worries on. They can be a beast to figure out sometimes, but I think that is the most important thing to concentrate on figuring out.

    Good luck!
     
  14. TheFormerLantusFiend

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    Sometimes if I inject in a muscle my blood sugars drops really fast. Unfortunately, I cannot wait 15 minutes to eat unless I start out high (although I might wait 15 minutes for a 168).

    In the first few months after I was diagnosed with diabetes, although I was not technically honeymooning, I did have a few really awful meals where I kept being low (30s) despite eating 300+ grams of carbohydrate.
     
  15. maciasfamily

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    This is where a CGM comes in handy. The meter reading was probably right, but he was probably dropping fast from the playing. If he was dropping fast, you could have made a different decision, or had him start eating right after dosing him.

    This happens many times with our son, and I'm grateful we have the Dexcom to see where he's going to make better decisions. It has saved him numerous times.

    Glad he's ok and most especially that he recognizes his lows!
     
  16. Melissata

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    Activity for sure. It wouldn't hurt to dose just as he sits down to eat if he has been active. It happens to my daughter when I don't look at the one hour on her Dex to see that she is falling. She will be at 90 testing and low by the middle of the meal from exercise earlier in the day even.
     
  17. dshull

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    Thanks for all of your replies. I think the cause of this will remain a mystery. I actually don't think the activity could have dropped him like that because he had no IOB for the later half of the afternoon. He only take Humalog with meals and does not take basal insulin. His lunch insulin had been at 12:30, and this was at 6 PM, so until I gave him the 2.5 units for dinner coverage, he had no IOB. And I don't think there is anyway that Humalog could work like that in just 20 minutes. So I think the Humalog had something to do with it, but the rest is really a mystery!
     
  18. Sarah Maddie's Mom

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    You don't need IoB for exercise to drop bg, especially in a honeymooning kid who may in fact have some of his own insulin on board. A delay of a few or up to 8+ hours for exercise induced lows is common.
     
  19. wilf

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    I think this is it, if there was no prior insulin still working.
     

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